Problem
Jarina is a 54 yo female who comes to your Family Practice with a concern about urinary incontinence. She is especially bothered by it as she engages in ballroom dancing as a hobby and also bicycles long distances on her days off. She is a well-known geo-political journalist who travels around the world to many underdeveloped countries with access to "facilities" limited at times. Her incontinence is worsening. The medical assistant has just finished logging in the preliminary info which is:
Vitals: T 98. HR 68 RR 20 B/P 130/80 Weight 130 Ht 5.5" BMI 22.5
Meds: Flexeril (cyclobenzaprine), Benadryl (helps w sleep) Social: tobacco (3-4 cigs day). Wine 1-2 glasses 4-5 x week
In taking a history your note the following: She reports UI when she is performing certain jumps and leaps during her ballroom dancing and when she rides up and down long hills while cycling. In addition she notes incontinence at times when she has delayed access to a bathroom facility and just can't make it in time.
a) What type of UI does Jarina have?
b) List the "systems" you would examine in her physical exam and why
c) What diagnostic test (s) would you order at this point
d) List your treatment plan.